What email address may we contact you with any questions we have about
the information you are providing us in this form?:
(use your Tab key or mouse to move from box to box)
Church Name:
Church Location (city):
Street Address/Physical Location:
Mailing Address:
Worshipping at Physical Location:
Phone:
FAX:
General Church Email:
(example: info@church.org)
Church Website:
(example: www.mychurch.org)
Vestry
Bishop's Committee
Senior Warden:
Sr Warden Mailing Address:
Sr Warden Phone:
Sr Warden Email:
Junior Warden:
Jr Warden Mailing Address:
Jr Warden Phone:
Jr Warden Email:
Clerk:
Clerk Mailing Address:
Clerk Phone:
Clerk Email:
Treasurer:
Treasurer Mailing Address:
Treasurer Phone:
Treasurer Email:
Others on Vestry/Bishop's Committee:
Church Secretary:
Secretary Email:
Administrator:
Administrator Email:
Christian Education Director:
Christian Education Director Email:
Youth Leader:
Youth Leader Email:
Organist/Musician:
Organist/Musician Email:
Choirmaster:
Choirmaster Email:
Webmaster/Computer person:
Webmaster/Computer person Email:
Newsletter Editor:
Newsletter Editor Email:
Other Congregational Leaders including clergy:
Our annual meeting was held:
,2008
Rector, Vicar, Priest-in-Charge:
Rector, Vicar, Priest-in-Charge Personal Email:
Other Staff Member:
Position/Title:
Email:
Other Staff Member:
Position/Title
Email:
Other Staff Member:
Position/Title
Email:
Other Staff Member:
Position/Title
Email:
Communicant: a baptized person who is faithful in corporate
worship and has received the Sacrament of Holy Communion in the Church
at least three times during the preceeding 12 months. Canon 20, section
1
Our number of communicants is
Number of Delegates based on Communicant strength in
accordance with the following: (Canon 2, section 1)
Any number not over 200
201-400
401-600
601-900
901-1200
more than 1200
2 delegates
4 delegates
6 delegates
8 delegates
10 delegates
12 delegates
Our number of delegates is
Our region is
Mt Baker
Sno-Isle
Be-Attitudes
Holy C
Eastside Episcopal Churches
Evergreen
Rainier
Peninsula
Columbia
Willapa
1. Delegate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Delegate's Email:
Phone
2. Delegate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Delegate's Email:
Phone
3. Delegate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Delegate's Email:
Phone
4. Delegate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Delegate's Email:
Phone
5. Delegate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Delegate's Email:
Phone
6. Delegate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Delegate's Email:
Phone
7. Delegate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Delegate's Email:
Phone
8. Delegate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Delegate's Email:
Phone
9. Delegate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Delegate's Email:
Phone
10. Delegate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Delegate's Email:
Phone
11. Delegate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Delegate's Email:
Phone
12. Delegate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Delegate's Email:
Phone
1. Alternate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Alternate's Email:
Phone
2. Alternate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Alternate's Email:
Phone
3. Alternate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Alternate's Email:
Phone
4. Alternate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Alternate's Email:
Phone
5. Alternate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Alternate's Email:
Phone
6. Alternate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Alternate's Email:
Phone
7. Alternate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Alternate's Email:
Phone
8. Alternate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Alternate's Email:
Phone
9. Alternate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Alternate's Email:
Phone
10. Alternate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Alternate's Email:
Phone
11. Alternate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Alternate's Email:
Phone
12. Alternate Last Name, First Name
Female
Male
Mailing Address
City
State
Zip
Alternate's Email:
Phone